Q: My 41 years old wife underwent complete hysterectomy 1.5 years back, because of heavy and irregular bleeding (caused by a non-malignant fibroid). After three months of operation she was put on HRT. She uses oestradiol patches for three weeks and repeats the course after one week. Her problem is that during the use of patches she has continuous headaches and occasional hot flashes. Despite the willingness to have sex she does not enjoy it i.e. neither she is aroused nor has any pleasant feeling. This makes her very upset and I too feel bad. Please advise an efficacious regimen of HRT which is safe and helpful in awakening her libido.

A:Recent research recommends restricted use, only in special cases, of HRT. It is better to use local oestrogen cream [evalone cream], applied daily intra-vaginaly before going to bed, and alternative therapy like Soya-estro or evanova capsules twice a day along with calcium and B complex. Life style modification - yoga, meditation, walking or exercise - are very important in post menopausal treatment.